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Infectious Flashcards

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1
Q

What is feline leukemia virus (FeLV)?

A

An infectious retrovirus in cats that leads to immunodeficiency and severe illness as a result

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2
Q

How is FeLV transmitted?

A
  • Saliva(ex. allogrooming and other social behaviours)
  • Respiratory secretions
  • Milk (vertical transmission)
  • Urine and feces
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3
Q

Which groups of cats are at higher risk for FeLV?

A
  • Kittens < 4 months
  • Negative cats housed with infected cats
  • Outdoor cats
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4
Q

What are the three main pathways of FeLV infection?

A
  1. Abortive
  2. Regressive
  3. Progressive (persistent viremia and high risk of FeLV-related disease)
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5
Q

What is the abortive pathway of FeLV?

A

Cats that have an effective immune response will completely eliminate the virus before it becomes incorporated into their genome. There isnoviral replication, viremia, or shedding of the virus

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6
Q

What occurs before the regressive pathway of FeLV?

A

Transient viremia to viremia phase

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7
Q

How long does the transient viremia stage of FeLV infection last?

A

6-8 weeks

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8
Q

What occurs during the transient viremia stage of FeLV?

A

The cat is infectious and the virus replicates in lymphoid tissue and GI tract

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9
Q

What is the regressive pathway of FeLV?

A

The virus integrates into the cat’s genome but prolonged viral replication is prevented. There isno viral sheddingandnoFeLV-related disease.
Caution: Will transmit infection if used as a blood donor!

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10
Q

What is the progressive pathway of FeLV?

A

There is extensive viral replication first in lymphoid tissue, then bone marrow, and subsequently in mucosal and glandular epithelial tissues. Viral shedding also occurs

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11
Q

True or False: A cat in the regressive stage of FeLV can revert at any point to the progressive stage

A

True. This become more and more rare as time goes on, but it can occur with stress.

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12
Q

True or False: A cat in the regressive stage of FeLV can revert at any point to the abortive stage

A

True, but this is extremely rare.

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13
Q

True or False: A cat that progresses through the abortive pathway of FeLV will have a lifelong protection to FeLV

A

TRUE

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14
Q

How is FeLV diagnosed?

A
  • ELISA Antigen Test (SNAP) (screening)
  • PCR (confirmatory)
  • IFA (not commonly performed) (confirmatory)
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15
Q

What does the ELISA FeLV SNAP test measure?

A

Free soluble p27 gag protein (antigen)

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16
Q

What does the FeLV PCR test measure?

A

Presence of proviral DNA (if there is viral DNA incorporated into the genome)

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17
Q

What does the FeLV IFA test measure?

A

p27 gag protein in WBCs or plateletsreleased from bone marrow after virus replication

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18
Q

An ELISA for FeLV is usually positive within _____ days of viral exposure

A

30

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19
Q

True or False: A cat that progresses through the abortive pathway of FeLV will have antibodies to FeLV

A

True (this will be the only indication they had FeLV)

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20
Q

What would the diagnostic results be for a cat withabortiveFeLV?

A

Negative for all tests (ELISA, PCR, and IFA)

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21
Q

What would the diagnostic results be for a cat in the transient viremia or viremia stage of FeLV?

A

Positive on both PCR and ELISA but negative on IFA
A positive IFA indicates viral replication in the bone marrow - difference between progressive and transient or regressive

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22
Q

What would the diagnostic results be for a cat withregressiveFeLV?

A

Positive on PCR but usually negative on ELISA and IFA.

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23
Q

What would the diagnostic results be for a cat withprogressiveFeLV?

A

Positive on all tests (PCR, ELISA, and IFA)

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24
Q

Which pathways of FeLV infection result from an initiallyineffectiveimmune response?

A

Both progressive and regressive

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25
What conditions does FeLV predispose cats to (six)?
- Infections - Immune-mediated disease (If you see IMHA or ITP in a young cat, test for FeLV!!) - Anemia - Lymphoma - Leukopenia/thrombocytopenia - Gingivostomatitis - Leukemia (rare even though this disease is called leukemia virus)
26
What are the most common clinical signs of FeLV?
- Pale gums and pallor - Weight loss - Fever Non-specific!
27
What are the most common CBC changes seen with FeLV (three)?
- Anemia (regenerative or non-regenerative) - Leukocyte abnormalities (neutropenia or lymphopenia) - Platelet abnormalities
28
Which neoplasias does FeLV cause?
- Lymphoma (mediastinal/thymic or multicentric) - Leukemia (you'd think this would be number 1 but no) - Fibrosarcomas - Osteochondromas - Olfactory neuroblastomas
29
True or False: Cats with FeLV have a higher risk of neoplasia than cats with FIV
TRUE
30
True or False: Maternal antibodies interfere with FeLV testing
False! They do not interfere!
31
When should you retest a negative ELISA FeLV test?
- If kitten is < 12 weeks old (test has lower sensitivity to kittens) - If it has been < 30 days since initial exposure (pre-viremia phase)
32
What should be done if a ELISA FeLV test is positive?
- Retest in 8 weeks in case they clear the virus (remember the transient viremia stage) - Run a PCR or IFA (if positive they are infected, if negative they are probably truly negative)
33
How can you monitor healthy cats that are FeLV+?
- Keep indoors only and neuter - Recheck PE and CBC at least twice yearly - Administer peri-operative antibiotics for surgeries or dentals - Avoid raw diets - Vaccinate with core-killed vaccines (try not to use modified live)
34
How can you monitor sick cats that are FeLV+?
- Treat any concurrent disease - Blood transfusions - Give erythropoietin and darbepoietin (to stimulate bone marrow RBC production) - Give filgrastim/neupogen (to help with neutropenia) - Chemotherapy (if they have lymphoma)
35
How can FeLV be treated?
- Zidovudine (AZT) (blocks retroviral reverse transcriptase) - Feline interferon-omega (not available in North America)
36
True or False: There is a vaccine for FeLV
True (but test prior to vaccination)
37
True or False: Vaccines for FeLV will prevent against a transient viremia
False! It does not prevent transient viremia but they will likely go into the abortive stage
38
True or False: Vaccination for FeLV will cause a positive FeLV test result
FALSE
39
What is the prognosis for FeLV?
Poor (50%-80% will die in the first 3 years)
40
How is FIV transmitted?
Bite wounds (virus exists in salivary epithelium, saliva, lymphocytes, plasma, and serum but vertical transmission is possible)
41
The rate of pathogenesis of FIV is influenced by which factor?
Age (cats infected at a younger age will develop clinical signs faster)
42
What is the hallmark of FIV pathogenesis?
The infection of and decrease in lymphocytes resulting in the progressive disruption of normal immune function
43
What are the clinical signs of FIV?
- Stomatitis (very common) - Pyrexia - Non-specific signs (weight loss, anorexia, lethargy)
44
What might you see on a chemistry panel with FIV?
- Hyperglobulinemia - Azotemia leading to CKD (rare)
45
How is FIV diagnosed?
- ELISA Antigen Test (SNAP) - PCR - Western Blot - IFA (no one does this though)
46
What does the ELISA SNAP test measure for FIV?
FIV-specific antibodies
47
What should be done if a FIV test is positive?
If they are < 6 months old - Likely maternal antibody is present so retest when they are > 6 months of age if they are > 6 months old - Reassess with Western blot or PCR
48
What should be done if a FIV test is negative?
- If exposure was < 60 days before testing, retest at 60 days (a minimum of 60 days after exposure to allow time for seroconversion) - If not, the cat is likely not infected
49
True or False: Maternal antibodies interfere with FIV testing
TRUE
50
Maternal antibodies interfere with testing for which disease?
FIV
51
Which main neoplasia does FIV cause?
Lymphoma (less risk than FeLV cats but an increased risk compared to normal cats)
52
True or False: Cats with FIV have a higher risk of neoplasia than cats with FeLV
False. Cats with FeLV have a higher risk of neoplasia
53
How can FIV be treated?
- Antivirals (AZT) - Complete dental extractions - Human interferon alpha (effective but almost never used)
54
How can FIV be managed?
- Keep indoors - Vaccinate for other infectious diseases - Keep away from healthy cats
55
True or False: There is a vaccine for FIV
False (not available in North America)
56
True or False: The prognosis for FeLV is worse than FIV
TRUE
57
What is feline infectious peritonitis (FIP)?
An immune-mediated disease caused by mutation of enteric feline coronavirus (FCoV)
58
How is FIP transmitted?
Trick question - it is not contagious! Careful because the enteric (non-mutated) form of coronavirus is contagious
59
How does the mutation change the enteric coronavirus seen in cats?
The mutation allows the virus to replicate in macrophages
60
What percent of normal/enteric coronaviruses mutate into FIP?
5%
61
How can FIP be diagnosed?
- RT- PCR of abdominal or thoracic effusion(coronavirus should never be in macrophages or in anytype of effusion) - Effusion analysis - Immunofluorescence (IHC) staining of effusion - Rivalta's test (simple but rarely done)
62
What are the three possible pathways of infection with FIP?
1. Body clears infection via cell-mediated response 2. Wet form 3. Dry form
63
What lesions are seen with the dry form of FIP?
Granulomatous lesions form with immune complexes
64
What lesions are seen with the wet form of FIP?
Vasculitis or effusion in pleural or abdominal space
65
What age of cats more commonly get FIP?
3 months to 3 years or > 13 years
66
What are the clinical signs of FIP?
- Fever - Uveitis - Abdominal distension - Dyspnea or tachypnea - Muffled heart sounds - Icterus - Enlarged abdominal lymph nodes - Neurologic signs - Non-specific (weight loss, anorexia, diarrhea)
67
Why is a fecal coronavirus antibody test not recommended for the diagnosis of FIP?
Because so many cats will be positive as the normal enteric coronavirus is common
68
How can FIP be diagnosed from a CBC?
Pancytopenia
69
How can FIP be diagnosed from a chemistry panel (two)?
- Hyperglobulinemia (seen in either form - mainly gamma globulins) - Albumin/globulin ratio < 0.8 - Hyperproteinemia - Hyperbilirubinemia
70
How can FIP be diagnosed from a urinalysis?
Proteinuria (sometimes)
71
How can FIP be diagnosed from effusion (three)?
- High protein count (> 3.5 g/dL) - Lower cellularity (< 5000 nucleated cells/mL) (protein rich transudate most common but can also be exudate) - Pyogranulomatous effusion (macrophages and neutrophils - effusion is very viscous)
72
How can FIP be treated?
Nucleoside analogues like GS-441524 (oral) and Remdesivir (injection)
73
What is the prognosis for treatment of FIP?
85% cats survive, especially if response in first 30 days (relapse is common)
74
How can FIP be prevented?
Technically this disease is considered non-contagious. However, if you had a FIP positive cat it is not recommended to get a new cat (or if the FIP cat is gone, wait 3 months before getting a new cat as the enteric coronavirus is contagious and may be more likely to mutate into the FIP strain)
75
What is the top differential for protein rich transudate on thoracocentesis?
FIP
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